胃癌侵及胰腺的外科治疗

目的：探讨胃癌侵及胰腺外科治疗的手术适应证和术式选择。方法：回顾性分析我院1984年6月至2001年6月对58例胃癌怀疑侵及胰腺的患进行手术治疗的临床资料。结果：扩大根治切除组（联合胰腺切除）36例，经病理证实胰腺有癌细胞浸润24例（66．7％），淋巴结转移30例（83．3％），姑息切除组22例，术后并发症发生率15．5％，其中扩大根治切除组为16．7％，姑息切除组为13．6％，两差异无显性意义（P＞0．05），两组无手术死亡，随访48例，术后1、3、5年生存率扩大根治切除组分别为75．0％，38．9％，19．4％，姑息切除组分别为22．7％，9．1％，4．5％，扩大根治切除组术后1、3年生存率明显高于姑息切除组（P＜0．005），结论：对胃癌侵及胰腺的患，扩大根治切除可提高1、3年生存率，但选择适应证甚为重要。

Surgical treatment of the gastric cancer invading the pancreas

Objective To investigate the surgical treatment of the gastric cancer invading the pancreas. Methods From June 1984 to June 2001,58 patients with gastric cancer and suspected of pancreatic invasion underwent extended radical resection or palliative resection.Clinical data of these patients were analyzed retrospectively. Results Among 58 cases suspected of pancreatic invasion, extended radical resection was performed in 36 cases and palliative resection in 22 cases. In extended radical resection group, pathological results revealed pancreatic invasion in 24 cases ( 66 7%), lymph node metastasis in 30 (83 3%). The postoperative morbidity rate was 16 7%(6/36) in extended radical resection group and 13 6%(3/22) in palliative resection group (P >0 05) respectively. No perioperative death occurred. Forty eight cases were followed up and 1,3 and 5 year survival rates were 75 0%,38 9%and 19 4%in extended radical resection group and 22 7%,9 1%and 4 5%in palliative resection group respectively. The 1,3 year survival rates in extended radical resection group were significantly higher than those in palliative resection group (P< 0 005). Conclusions As for the patients with gastric cancer invading the pancreas, extended radical resection can improve the 1, 3 year survival rates and the selection of operation indications is crucial to the prognosis.